Balancing Capacity with Demand at Dumfries and Galloway Royal Infirmary

A large rise in the number of visitors to the Emergency Department prompted Dumfries and Galloway Royal Infirmary to undertake an urgent review of patient flow. The hospital's improvement team decided to implement Daily Dynamic Discharge[1]on one ward after being inspired by a workshop at a National Unscheduled Care event. It proved such a success that the model has now been implemented across the hospital and is being rolled out to the community. This is their story…

Winter 2015/16 proved particularly tough for Dumfries and Galloway Royal Infirmary. Between 1 November 2015 and 28 February 2016, visitors to the Emergency Department rose by 3.2%, compared to the same period the previous year. Over the same period, medical admissions from the Emergency Department went up by 30% on the previous year.

In May 2016, the hospital carried out a day of care survey [2] which revealed that more than a fifth of patients (22%) were in hospital unnecessarily. There was clearly an urgent need to ensure that only patients with a clinical reason to be there were occupying a hospital bed.